Medicare Special Needs Plans - NYS 2021 - lists compiled from CMS lists. Includes plans in new federal program to cover insulinat $35 per month supply, and for DUAL-SNPS (D-SNPS) indicates if plan is "FIDE" or "HIDE" fully-integrated plans integrating Medicare and Medicaid, some with integrated appeals. These fully integrated plans are also known as Medicaid Advantage Plus (MAP).. See this article http://www.wnylc.com/health/entry/225/ about integrated appeals for MAP plans.

Comments filed on May 5, 2021 in response to the State Dept. of Health's proposal to CMS on how it will implemenet the 30-month Lookback, that was enacted in the NYS FY 20-21 Budget, and applies to MLTC enrollment and all other home care and the Assisted Living Program. The State's proposal can be viewed at https://health.ny.gov/health_care/medicaid/redesign/mrt2/proposals/30-month_lookback-final.htm

Letter to Governor Cuomo and leaders of the legislature calling for NYS Budget initiatives that will ensure access to home care to prevent unnecessary institutionalization -- COVID-19 has been a wake-up call for the need to avoid nursing home placement when ever possible.

NYLAG's comments submitted on the 2nd round of proposed State regulations implementing 2020 changes in State law restricting eligibility for personal care, CDPAP and MLTC enrollment, and changing the procedures for how Medicaid home care services are assessed. The proposed State reg can be found at https://health.ny.gov/health_care/medicaid/redesign/mrt2/express_terms_summary.htm. The NYSBA Elder Law & Special Needs Section comments are also attached to and referenced in the NYLAG comments.

NYS DOH has requested that CMS change the 1115 waiver that governs MLTC and managed care in 2 ways. (1) Restrict enrollment in MLTC to those meeting new 2- or 3- ADL requirement enacted in State budget in April 2020; (2) Keep people in mainstream Medicaid managed care plans when they start getting Medicare, if they are enrolled in a Dual-Special Needs Plan. They could opt out but otherwise would automatically stay in managed care. See waiver request at https://content.govdelivery.com/accounts/USCMSMEDICAID/bulletins/2aea7cd. NYLAG comments posted here

Comments filed by NYLAG dated Oct. 29, 2020 on the proposed Medicaid State Plan Amendment (SPA) that would restrict elgibility for personal care and CDPAP services to require 2 or 3 ADL needs. The proposed SPA No. 20-41 was posted September 29, 2020 and is available at https://www.health.ny.gov/regulations/state_plans/status/ltcare/original/docs/os_2020-09-29_spa_20-41.pdf.

The US Dept. of Health & Human Services (HHS) has proposed a "sunset regulation" that would retroactively impose a mandatory expiration date on an estimated 18,000 duly promulgated regulations for programs ranging from Medicaid and Medicare to the FDA and CDC. NYLAG submitted comments on these rules.

This advocacy memo from NYLAG explains the rules regarding treatment of pre-paid funeral agreements for burial arrangements for Medicaid eligibility for people age 65+, blind, or disabled.

NYLAG PowerPoint presentation explaining the Medicare Part D program, with changes for the 2021 calendar year. The annual enrollment period for 2021 began Oct. 15, 20 and goes thru Dec. 7, 2020.

Benchmark Part D plans in NYS 2021 - Free Premiums for People with Extra Help/ Low Income Subsidy - Seven plans will be free for those with full Extra Help. Two plans that were benchmark in 2020 are closing in 2021. This fact sheet explains how members of those plans can ensure full access to covered prescriptions in 2021.